Background: According to WHO Congenital anomalies are defined as structural or functional anomalies, including metabolic disorders which are present at the time of birth. Congenital anomalies are a major health problem accounting for 8% to 15% of perinatal deaths and 13% to 16% of neonatal deaths in India. This study was done to know the frequency, pattern of congenital anomalies and various presentations, which may help to develop strategies for patient counseling and management. The objective of study was etiology of fetal anomalies during pregnancy in district headquarters hospital Khammam. Methods: A prospective observational study regarding etiology of fetal anomalies during pregnancy and its neonatal outcome, analytical hospital based study of 300 patients who delivered or aborted congenital anomalous baby from a period of 1st september 2021 to 31st March 2022.Results: In this study, we observed few multiple congenital anomalies are Acrania, atrioventricular septal defect and single umbilical artery, choroid plexus cyst and single umbilical artery, mega cisterna magna, small bowel obstruction and single umbilical artery, small bowel obstruction and hydronephrosis, vasa previa and Oligohydramnios. The neonatal outcome of all these anomalies